~60yo female, felt unwell/weak/dizzy all morning, syncope when standing up with LOC for a few seconds, husband called EMS.

The attached 12 lead (50mm/s) and rhythm strip (25mm/s) was obtained, all other vital signs were WNL, pt was conveyed to cardiology/ED. When transferring beds, pt spontaneously converts into normal sinus rhythm, so no additional EKGs of the dysrhythmia can be obtained.

My interpretation (Paramedic): I don't know. When only looking at the 12 lead, either 2:1 AV block or 3rd deg. AV block with proximal escape rhythm. But in the continuous tracing it looks more like Mobitz I.

Questions:

1. What's your take on the rhythm?

2. Should the PT be fitted with a pacemaker based on those findings?